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Discover The Secrets To Become Fertile
Discover The Secrets To Become Fertile

Dr Paras Shah

Chief Consultant Sexologist & Fertility Specialist

SAL Hospital

Rajasthan Hospital

"So, when are you planning to have a baby?" This is the commonest question most newly married couples in India are asked - sometimes even as soon as they have returned from the honeymoon! There is a lot of pressure on couples to have a baby, especially in traditional families, where the wife's role is still seen to be one of perpetuating the family name by producing heirs.

Many couples still naively expect they will get pregnant the very first month they try (the result of watching too many Hindi films, perhaps!) and are concerned when a pregnancy does not occur. They go through a brief interlude of doubt and concern when they do not achieve pregnancy the very first month they try and start wondering about their fertility.

Like a surprising number of couples these days you've been hit with a bolt out of the blue... you're infertile. Whether you're newly diagnosed or have been dealing with the discovery for a while now, what you learn here will make all the difference in whether you ever hear your own child call you "Dad or Mummy".

Before worrying, remember that in a single menstrual cycle, the chance of a perfectly normal couple achieving a successful pregnancy is only about 25%, even if they have sex every single day.

Getting pregnant is a game of odds - it's a bit like playing Russian Roulette and it's impossible to predict when an individual couple will get pregnant! However, over a period of a year, the chance of a successful pregnancy is between 80 and 90%, so that 7 out of 8 couples will be pregnant within a year. These are the normal "fertile" couples - and the rest are "labeled" infertile - the medical text book definition of infertility being the inability to conceive even after trying for a year.

Like more than ten million other Indians, Rakesh and Jolly desperately wanted a baby but couldn't seem to conceive. After a consultation, they were sent home with doctor's orders: Have sex when Jolly was most fertile, and have it often.

While that may sound like a dream come true, infertile couples like the Priya say it can be stressful. "I didn't want to be one of those women tapping on her watch, saying 'Now' at the bedroom door," says Jolly, "so I tried to be seductive in creative ways."

They both put more emphasis on foreplay, for instance, so they didn't view each other simply as an egg manufacturer and a sperm-delivery guy. "I'd try to think of my husband as a sexy man, not just the guy who didn't get me pregnant," says Jolly. "Sometimes, before intercourse, I'd focus on some physical aspect of him that I particularly adore, and that would turn me on."

Obviously, it worked -- the Priyas' daughter, Vidhi, is now three.
The Stopwatch Mentality

Sex can become tedious when they have to time intercourse to accommodate numerous lab tests or maximize their chances of success. Spontaneity can be replaced with sex as a compulsory act sex on a schedule.

Besides this timetable pressure, there can be loss of self-esteem (if, for instance, the woman feels like a failure for not becoming pregnant) and the financial burden of fertility treatments. But through it all, there are ways to minimize the toll.
How Women and Men Respond

First, a couple should understand that each of them tends to react a bit differently, experts say. "A woman in this situation may feel alienated from her body, so it may be hard for her to feel sexual," says Dr Archana Shah, Consultant Gynecologist and fertility Specialist, Rajasthan Hospital, Ahmedabad. "She may feel like little more than a set of ovaries and even begin asking herself, 'What's the point of having sex if I'm not getting pregnant?' "

Lack of desire, in turn, can decrease natural lubrication, making sex painful, Dr Archana says, and resulting in even less sex.

In addition, A man may feel like nothing more than a sperm donor and become so distanced that he has difficulty achieving erection or orgasm. Some men even fake orgasm to get sex over with.
Relieving the Pressure

Both partners should avoid getting into "performance" mode. It can help to realize that the window of opportunity for conception stays open longer than what is suggested in movies, where characters often engage in lunch-hour sex in order to conceive while the woman is fertile. Sperm can live in the cervical mucus for about two days before ovulation, according to Dr Archana.

In general, infertile couples are advised to have intercourse between 12th and 18th day of her period, if possible every other day. These are the fertile days for her. Simply stated, the more sex the better! Couples who have intercourse less frequently, have a diminished chance of conceiving. I tell all my patients Ė itís much more fun making a baby in your bed room than coming to me! (And think of all the money youíll be saving Ė itís like being paid to make love to your wife !)

Also remember that you cannot "store up" sperm, which means that there is really no advantage to abstaining from sex if you are trying to conceive. In this case, more is better, and in fact studies have shown that fresh sperm have a better chance of achieving a pregnancy than sperm which have been stored up for many days.

However, sex shouldn't be confined to the time of fertile days. Unless instructed otherwise by their doctor, couples should make love throughout the month, not just when they think they might conceive. That might help them separate sex from conception and sex will become a natural part of life again.
Sex as Recreation, Not Just Procreation

Thinking of sex not as a chore but as fun, the way it used to be, can help. "We did our best to have a good time -- having sex in different rooms, different positions and go to even hill station," Mahi recalls.

Couple should set a romantic mood with things like shared baths and massages. It's also a good time to explore sexual fantasies and erotica.

If you have been having sexual intercourse two or three times a week at about the time of ovulation, without any form of birth control for a year or more and are not pregnant, you meet the definition of being infertile. Pregnancy may still occur spontaneously, but from a statistical point of view, the chances are decreasing and you may now want to start thinking about seeking medical help. There is no "right" time to do so and if it is causing you anxiety and worry, then you should consult a doctor. Even though you may be embarrassed and feel that you are the only ones in the world with the problem, you are not alone. Many couples experience infertility and most of them can be helped.

Unfortunately, while infertility is always an important problem, it is usually never an urgent one. This often means that couples keep on putting off going to the doctor. "We'll take care of it next month". Tragically, many find that time flies, and before they realize it, their chances of getting pregnant have started to decline, even before they have had a chance to take treatment properly. Set your priorities, so that you have peace of mind that you tried your best. After all, if you don't take care of your own infertility problem, who will ? Kicking yourself when you are 40 years old for failing to take treatment when you were younger will not help. Remember that everything in life comes back, except for time!

Staying positive and looking ahead to the day would hold a brand-new family member in your arms.

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Falling In Love Is The Best Arthritis Medicine Of All
Falling In Love Is The Best Arthritis Medicine Of All

Here's the good news: People with arthritis who go ahead and have sex, despite the pain in their joints, often report that their joints are pain-free for more than 6 hours afterward. Sexual arousal touches off a cascade of blissful hormonal changes, boosting the production of corticosteriod, a hormone that reduces pain and inflammation in the joints, as well as endorphins, the body's natural opiates. (By some lights, falling in love is the best arthritis medicine of all. Heart surgeon Christiaan Barnard, for instance, suffered from rheumatoid arthritis for years before he married a ravishing young woman named Barbara. "For several years after the wedding," he reported later in a book, "I virtually ceased to be a sufferer.")

Okay, now here's the bad news: About half of the Indians who suffer from some form of arthritis also complain that it interferes with their sex lives. In fact, people with rheumatoid arthritis, a severe form of the disease much more likely to affect women than men, have a higher divorce rate than people with most other kinds of chronic disease.

Some women with rheumatoid arthritis sail through menopause without a care while others experience a full menu of menopause symptoms: hot flashes, insomnia, mood swings, weight gain. Menopause can also increase symptoms of rheumatoid arthritis, such as joint pain and fatigue.

There is actually a slight rise in new diagnoses of rheumatoid arthritis in women around the onset of menopause. The fact that menopause can aggravate rheumatoid arthritis symptoms are probably related to the bodyís drop in estrogen, which is believed to affect rheumatoid arthritis. That may also be why pregnant women who have higher levels of estrogen while they're expecting may see their rheumatoid arthritis symptoms get better for a while.

Whether you've lived with rheumatoid arthritis for a while or just been diagnosed, menopause can pose new challenges to sex, intimacy, and overall well-being. You may feel that because menopause signals the end of fertility, it also means the end of sex. But women with rheumatoid arthritis can have a thriving sex life well past menopause. Work closely with your doctor, talk honestly with your partner, and try these strategies to help you move smoothly through this life passage.

Rheumatoid Arthritis, Menopause, and Vaginal Dryness
One of the first symptoms of menopause that many women experience is vaginal dryness. And it can be a special problem if you have SjŲgrenís syndrome, a condition often seen with rheumatoid arthritis that includes eye, mouth, and vaginal dryness as well as fatigue and achiness. Vaginal dryness can make sex uncomfortable or even painful.

Lowered Sex Drive
Some women feel less interest in sex during or after menopause. That's true for some women even without rheumatoid arthritis. But living with rheumatoid arthritis can also stifle your libido. For example, if you take high doses of steroids to control inflammation, it may cause you to gain weight which in turn could make you feel less interested in sex.

Worrying about pain during sex can kill desire too. And your partner may hold back from sex out of fear of hurting you.

Not Tonight, Honey. Iíve Got Joint Pain.
Swollen and painful joints can put a damper on having sex, and menopause and aging can increase joint pain and stiffness in some women. For women who have relatively severe disease, finding a comfortable position for intercourse may be challenging. In some instances, when pain is especially severe, a woman may not even feel like having intercourse.

Talking to a doctor can also open up discussion between you and your partner. Discussing sex openly is critical. It gives you both a chance to air your fears and feelings, and can make your relationship stronger.

You Can Enjoy Sex

Here are some other ways to make sex more painless and pleasurable.
Get ready. An hour beforehand, take whatever pain-relieving medication you're using. Avoid painkilling narcotics or other drugs that have sex-inhibiting side effects. Corticosteroids, for instance, may relieve pain in men, but they also suppress erection.

Loosen up. While you relax and get in the mood, try doing a few gentle range-of-motion exercises to limber up your joints.

Warm up. Take a warm bath or shower in preparation- or better yet, invite your partner to join you. Turn it into a slow, soapy, delicious form of foreplay.

Stay toasty. Try an electric blanket- it may keep your limber while it keeps you warm. Or what about a heated waterbed? Some arthritis sufferers say it makes all the difference.

Donít' forget to touch. Don't forget that physical love doesn't only mean intercourse- there's always kissing, hugging, caressing, stroking, massaging and a thousand other variations on the ecstasy of touch.

Lubricate. Some times women who have arthritis also suffer from Sjogren's syndrome, an unpleasant side effect that causes dryness of the mucous membranes around the eyes, mouth and vagina. It may help to use a germ-free, water-soluble suppository lubricant like K-Y Jelly, Lubrin or Steri-lube, which are available without a prescription in drugstores. (Petroleum jelly products and other oily substances should not be used, because they may harbor germs and cause infection.)

Experiment with times. Most people with rheumatoid arthritis have their most severe symptoms in the morning when they awaken. Symptoms are often lowest in midafternoon and tend to worsen later in the day. Try adjusting your timetable for lovemaking to coincide with the periods during which symptoms are less severe.

Experiment with positions. The usual missionary position may be very uncomfortable if the woman has arthritis in her hip or the man has it in his knee, leg or arm. The Arthritis Foundation puts out a nice little booklet about sex and arthritis called Living and Loving, which (among other things) describes seven positions likely to be more comfortable.

Reducing Fatigue
Menopause can increase fatigue, which you may already be feeling thanks to your rheumatoid arthritis. If thatís the case, the only thing you may want to do in bed is sleep. Menopause can also lead to insomnia, another problem for some women with rheumatoid arthritis.

Other tips: I suggests trying yoga, which may help with sleep, or talking to your doctor about a mild prescription sedative.

Intimacy and Depression
Depression is about twice as common in people who have rheumatoid arthritis as in people who donít. Itís not uncommon to feel depressed by rheumatoid arthritis pain or by not being able to do some things that you used to do.

Menopause can also bring on or increase depression. Some women, with or without rheumatoid arthritis, find that it takes a toll on their self-image, making them feel old, less attractive sexually, and insecure. Often those feelings pass. But if youíre worried about depression or you're having severe menopause symptoms, you may want to talk to your doctor about antidepressants.

The benefits of antidepressants go beyond relieving sadness and anxiety: They may reduce menopausal symptoms such as hot flashes as well the pain of rheumatoid arthritis. However some antidepressants may reduce your libido, so talk to your doctor if this is a concern.

Get Moving to Get Through Menopause
One of the keys to having a healthy sex life during menopause and beyond is taking care of your overall health. Eating well, keeping your rheumatoid arthritis symptoms under control with medication, and getting enough vitamins and minerals are essential.

Menopause may be a good time to try yoga, if you havenít before. It has shown promise in promoting joint health and emotional well-being, as well as reducing hot flashes.

The many benefits of exercise can also enhance self-image and thatís good for anyoneís sex life.

Sexual communication- letting your partner know what feels good and what doesn't- is so important. Good communication is important in any sexual relationship, of course, but when you've got arthritis hanging over the bed, there's a great potential for hurt feelings.

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How You Can Have Better Sexual Life...
Erectile dysfunction, which affects an estimated 30 percent Indian and is more prevalent in men over 40, is defined as the inability to achieve or maintain an erection adequate for sexual function. Erectile dysfunction (ED) is common in older men. But it's not a normal part of aging. I recommends getting evaluated for cardiovascular risk if there is a persistent erectile issue that lasts for three months or longer.

Recent research has also shown that ED may be linked to diabetes, high cholesterol, hypertension, as well as the early stages of heart disease, so encouraging your man to set up a check up with his doctor is a good starting point.

The problem is, there are men who donít come in because of embarrassment and denial. If a man develops erectile dysfunction, he has a window of opportunity to make some lifestyle changes that may reduce his risk of having a heart attack.

How can you avoid ED? Here's what you can do.

1. Avoid high blood pressure and high cholesterol.

More than 50% of adults with diabetes have high blood pressure or take blood pressure medication. The combination of high blood pressure and diabetes also increases the risk for blood vessel damage, further reducing blood flow. Eventually, this can lead to ED.

Do regular cheack up with your doctor for your cholesterol levels and blood pressure.

2. Maintain a healthy weight.

Being overweight can bring many health problems, including type 2 diabetes, which can cause nerve damage throughout the body. If that affects the nerves affecting the penis, ED can result. Complicating matters further, the more body fat you have, the higher your level of SHBG (sex hormone binding globulin). The more testosterone that is bound to SHBG, the less there is available to stimulate desire. So lose a little weight, even 5 kg, can often free up testosterone and almost immediately give a boost to your love life.

3. Watch what you eat.

A diet that's bad for a man's heart is also bad for his ability to have erections.

If you eat a heart-healthy diet, the benefits to your heart will improve the blood flow to other organs in the body. And increasing the blood flow to sexual organs will increase desire and function. The same eating pattern that can cause heart attacks by impeding blood flow in the coronary arteries. Lots of fatty, fried, and processed foods can impede blood flow to and within the penis. That blood flow is needed for the penis to become erect.

Eating the right kinds of foods are just the prescription for a healthier sex life. Anything that is bad for a man's heart is also bad for his penis. Even simple diet modification such as following a low-fat diet and eating lots of fruit and vegetables that help get blood sugar and cholesterol under control can also help turn your sex drive around even if you don't lose weight.

4. Drink alcohol in moderation or not at all.

There is no evidence that mild or even moderate alcohol consumption is bad for erectile function. But chronic heavy drinking can cause liver damage, nerve damage, and other conditions that can lead to ED.
5. Do not take stress.

Psychological stress boosts levels of the hormone adrenaline, which makes blood vessels contract. That can be bad news for an erection. Anything a man can do to ease tension and feel better emotionally is likely to give his sex life a big boost.
6. Keep tabs on testosterone.

Even in healthy men, testosterone levels often begin falling sharply around age 50. Every year after age 50, a man's testosterone level typically falls about 2.0%.

Symptoms like a low sex drive, moodiness, lack of stamina, or trouble making decisions suggest a testosterone deficiency, as do spongy erections.
7. Avoid anabolic steroids.

These drugs, which are often abused by athletes and bodybuilders, can shrink the testicles and sap their ability to make testosterone.
8. If you smoke, stop.

Smoking cigarettes can harm blood vessels and curb blood flow to the penis. And nicotine makes blood vessels contract, which can hamper blood flow to the penis.
9. Steer clear of risky sex.

Some cases of erectile dysfunction stem from penile injuries that occur during sex. To keep your penis from bending painfully, start thrusting only after making sure her vagina is well lubricated. And make sure your penis doesn't slip out of the vagina while thrusting (so you won't accidentally jam your penis against a hard part of her body). If she moves in such a way that hurts your penis -- for instance, by bending it the wrong way -- have her stop at once.

If the woman is on top and comes down hard, and the penis does not enter the vagina, that is the equivalent of a big weight crashing down on the penis. No penis on earth can withstand that.
10. Exercise regularly.
Getting regular physical activity is an easy way to boost your sexual prowess. Adults who exercise regularly not only have increased levels of desire, but also enhanced ability to perform sexually and greater sexual satisfaction, Strong evidence links a sedentary lifestyle to erectile dysfunction. Running, swimming, and other forms of aerobic exercise have been shown to help prevent ED. One exercise for women is the Kegel -- the same exercise gynaecologists recommend to keep the pelvic floor strong during pregnancy. These muscles can increase pleasure sensations during sex. They're the same muscles you use to stop the flow of urine when you're using the bathroom. Just practice tightening them whenever you think about it during the day.

A healthy diet, regular exercise, and a positive attitude are only the beginning. It also helps to get plenty of sleep, quit smoking, and control the stress in your life. Not only will you look better, you'll feel good about yourself -- a real boost in the between-the-sheets department. A dash of positive attitude ties it all together: You have to believe you're hot if you want to make things sizzle in the bedroom. Being sexy and self-confident is just a state of mind.

Remember, a lifestyle that's healthy for you overall will be healthy for your sex life period. Boost your sexual potency naturally with a healthy diet, lots of physical activity, and an attitude that screams, "I'm worth it!"

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